DID CDC MAKE THE RIGHT CALL?

The CDC released new guidance today for folks that are fully vaccinated with the basic message that if you’re fully vaccinated, you can basically get back to pre-pandemic behavior. Today’s guidance says that fully vaccinated people can resume activities without wearing a mask or even physically distancing including in local business and workplace guidance (like healthcare facilities and where local rules still require masks).

Is this the right call? I think it is.

The CDC waited to make this policy change until the data were clear about how protective the vaccines are in real life. Importantly, they also waited for a sufficient number of Americans to get vaccinated, ensuring that we won’t have another hospital capacity crisis or even a significant rise in infections.

Will some unvaccinated people claim that they have been vaccinated and go to public places without a mask? Sure they will. Will that kind of behavior create a dangerous environment? Not really, because:

  • So many folks have now been vaccinated now (especially people over 65);

  • We now know that the real-life efficacy of the dominant vaccines is as good or better than what was found in the clinical trials;

  • We have evidence that persons that have been vaccinated are very unlikely to carry or shed the virus to others; and

  • The vaccines are working on all known variants.

I’m hoping that we see a bump in the number of people that get vaccinated because of this announcement. While it’s true that many unvaccinated people will say they are vaccinated in order to not be judged for not wearing a mask in public, many won’t want to. Some folks that have been on the fence will see that vaccines have a tangible real-life benefit and decide to finally go ahead and get vaccinated.

Let’s hope that this added incentive to get vaccinated makes a difference and more people that have been delaying getting the vaccine decide to take the plunge. But even if they don’t, today’s new recommendations are evidence-based, make common sense, and reflect the diminished risk that the virus now poses in the U.S.

Editorial Note: It’s important that we use evidence to drive our decision-making (and avoid making recommendations out of ‘an abundance of caution’). It’s also important for us to weigh risks and benefits when making policy. When we make decisions that are overly restrictive, that aren’t based on evidence, that don’t consider real risks in a clear-eyed fashion, or that don’t consider both the risks and benefits we risk losing our credibility with the public (e.g. we get a reputation for saying that the sky is falling).

Our credibility as a profession is really important because people will only follow our public health recommendations if they view us as reasonable and evidence-based.

P.S. The persons that could potentially be harmed by the CDC’s change in policy are those folks that are immunocompromised. Folks with weakened immune systems may not form a robust immune response after being vaccinated, and will need to keep in mind that some persons that they will see in the community without masks may not be vaccinated.

P.S.S. This virus is still posing and will continue to pose a substantial public health risk in many developing countries for many months and perhaps years to come. Our commitment to COVAX (the international effort to get vaccine to developing nations) is critical- not just because it’s our ethical responsibility as a rich nation to help less wealthy countries acquire vaccine, but also to prevent the virus from boomeranging on us. The more opportunities this virus has to mutate (e.g. worldwide infections) the more likely it is that a new variant will evolve that’s resistant to immunity acquired from previous infections or vaccinations- potentially resulting in COVID-22.

Want to learn more about these recommendations? Read the CDC’s expanded Public Health Recommendations for Fully Vaccinated People.

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